重度NPDR全视网膜光凝术后羟苯磺酸钙治疗的疗效分析

Effects of calcium dobesilate in the treatment of non-proliferative diabetic retinopathy after panretinal laser photocoagulation

目的:探讨重度非增殖型糖尿病视网膜病变(nonproliferative diabetic retinopathy,NPDR)全视网膜光凝术后行羟苯磺酸钙治疗的疗效。方法:选取40例62眼重度NPDR患者,随机分为对照组(22例31眼)和观察组(18例31眼)。两组患者均给予全视网膜激光光凝治疗,其中观察组术后给予羟苯磺酸钙12mo治疗。12mo后,观察两组患者治疗前后BVCA、视野平均阈值敏感度和视网膜神经纤维层厚度。结果:对照组和观察组治疗后视力有效率分别为55%、84%,治疗有效率比较,差异有统计学意义(P<0.05)。对照组术后12mo视野平均阈值敏感度较治疗前降低,差异有统计学意义(P<0.05);观察组术后12mo视野平均阈值敏感度较治疗前无明显改变,差异无统计学意义(P>0.05);术后12mo,两组患眼间视野平均阈值敏感度比较,差异有统计学意义(P<0.05)。对照组术后12mo的RNFL平均厚度与治疗前相比,明显变薄,差异有统计学意义(P<0.05);观察组术后12mo的RNFL平均厚度与治疗前相比,差异无统计学意义(P>0.05);术后12mo,两组患眼间RNFL平均厚度比较,差异有统计学意义(P<0.05)。结论:羟苯磺酸钙可有效减轻全视网膜光凝治疗糖尿病视网膜病变术后的远期视功能损伤,羟苯磺酸钙联合激光治疗较单纯激光治疗能更有效地改善重度NPDR患者的预后,提高患者的视力。

AIM:To investigate the effect of calcium dobesilate in the treatment of non-proliferative diabetic retinopathy(NPDR) after panretinal laser photocoagulation.METHODS:A total of 40 patients(62 eyes) with clinically diagnosed severe NPDR were randomly divided into control group(22 cases,31 eyes) and study group(18 cases,31 eyes).Two groups were all given pan-retinal photocoagulation treatment,while the study group continued to receive calcium dobesilate for 12 mo after treatment.After 12 mo,before treatment and 12 mo after treatment,the changes of best corrected visual acuity(BCVA),average threshold sensitivity,and retinal nerve fiber layer(RNFL) thickness were compared between two groups. RESULTS:The response rate was 55% and 84%,respectively in the control group and study group,the difference was statistically significant(P<0.05).Compared to the pre-treatment measurement,the average threshold sensitivity and RNFL were reduced at 12 mo after treatment in control group,the difference were statistically significant(P < 0.05).Compared to the pre-treatment measurement,the average threshold sensitivity and RNFL were reduced at 12 mo after treatment in study group,thedifference were not statistically significant(P> 0.05).At12 mo after treatment,the difference of the average threshold sensitivity and RNFL between two groups were statistically significant(P<0.05).CONCLUSION:calcium dobesilate could be effective in preventing the retina from damage of retinal photocoagulation in DR.Compared with simple laser photocoagulation,panretinal laser photocoagulation combined with calcium dobesilate can improve curative effect and visual acuity in NPDR patient.